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Home My WebLink About3424-zFORM NO. 4. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BERTIFIBATE BF EIP. P. UPANBY No. ~ ;~63 Date . ~ 2?' , 19 67 THIS CERTIFIES that the buildin~ located at ~/~ ~ ~ AVe ~ Street [Viap No.~ Block No. ~ Lot No.~ ~~d' ~'.% ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ~ .. ~0, 19 6~ pursuant to which Building Permit No. ~ ~ dated ~=~i l0 ,19 57 ' was issued, and conforms to all of the req~e- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ~Ri~a~ o~e. f~il~ .d~i~g ................................. The certificate is issued to ~ieholas ~ .~-. ~!a~lo~ ........ ,~e~- ...... [owner, lessee or ze[tant) of the aforesaid building. Suffolk County Department of Health Approval J%~I~ 26, !~6?.-b:~-~.,-%:t!la.. ........ Building Inspector [ FOR~'! NO. 2 TOWN OF $OOTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3424 Z Permission is hereby granted to: at premises located at ~-.~l.~h.t~ho~..~l:.&..~q~ql~..~j:~...:t~,e .................................................... ................................................ ~utno'~'d .................................................. pursuan.t to application dated ................... ~t~',~, ....... ],0 ................. , 19~7..., and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH JUL ~ 6 1B6"/ ~Zag. Perm±t No. ,,,~~ TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ./,~/~ SN~/#~ ~i E~! ,/~V~, ,~g~, ~'-/0 ~ / ~l/~.f z~'~,~ '~ (~ive dee~ locatiom) have been inspected by this department and found to be satisfactory. District Engineer District Engineer FOF,~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... ~....!...~.. ...... , 19...~.....~. Approved ........................................ , 19 ........ Permit No ................................. D~sapproved a/c ...................... APPLICATION FOR BUILDING PERMIT Date ................ ~....~....~.. ..... , , c)..(~....~... INSTRUCTIONS a. Th~s apphcation must be completely filled ~n by typewriter or in ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and g~wng a detailed description of layout of propertymust be drawn on the d~agram which ,s part of th~s applicat~or c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of th~s application, the Building Inspector will ~ssue a Budding Permit to the applicant Suc permit shall be kept on the premmes avatlable for inspection throughout the progress of the work. e No building shall be occupied or used ,n whole or m part For any purpose whatever until a Certificate of Occupanc shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c zR~geUla(~hp~,r~nftOra;rheeesC~StcL~mCtl~lOyn w~ifthbua~[~dianpg;~i~aadbd~i~an~vs~r~ar~t'enra~nt~c~er~b~?nr~de¢g~nns: as herein describe, .... ........ ...... £ ...... (Address of applicant) Il State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildei ................ ..................................................................................................................................................... owner of premises ...... '~' --/~lJ/(/..C.//Z.~....~,~ ....... ~',I.-~1.~.....~.~. ...... ~?~.~.~A<'.~~ ...................... Name of If applicant is a corporate, signature of duly authorized officer. .................... ............................. (Name and title of corporate officer) 1. Location of land on which proposed work will be done Map No ............................................ Lot No: .................. ' ' Street and Number ......... /~.~.l.~/-/v~.. ............................................................................................ Mumcipality 2. State ex~sting use and occupancy of premises and ~ntended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................................................................................... b Intended use and occupancy ....... >~.~'. :~. · 7~ .~. ......./~. · ~. · .~')~..~... ........................................................... 3. Nature of work (check which applicable): New Building ..... I,/.. ......... Addition .................. Alteration ................ Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... 4. Estimated Cost ........... L..~..~L.~...~.. ............................. Fee ........................................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ~'. ............... Number of dwelling units on each floor .......................... if garage, number of cars ........................... ~/ ............................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7 D~mens~ons of ex~sting structures, if any: Front ........ ~ ............... Rear .......... ~ ........... Depth ......'... .................. Height ............................ Number of Stories ............................................................................................................. D~mensions of same structure w~th alterations or additions' Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8 D,mens,ons of ent,re new construction: Front .... 6..~ ................ Rear .....~..~' ............... Depth ......a~. ............. Height ...~...~.. ............... Number of Stories ....... ~ .................. 9. S,ze of lot' Front ..... ~.~./..:..~...~..... Rear ..... /~.Z.~.....I~...~.... Depth ..... .~../.~. ................. 10 Date of Purchase ........ '~"~:~'l-' ...... /'~'~4"4~ ............. Name of Former Owner/~......~..~P~.VJ~. .......................... 12. Does proposed construction vi.olote~ony_ zoning Iow..ord,nance or regulation ...... :'"~"~'"~,'t;; ............................ 13 Name of Owner of prem,ses ~~ ~t~t~dress .... {..~.~.Z...~.....~.~..!/i~i... ~No. CL..~..~ Name of Architect .................................................... Address ......................................... ~boneblo ................... Name of Contractor .... .~,~ ........ Address .... ~.../~'~.~.~ PLOT DIAGRAM Locate dearly and distinctly all buildings, whether ex~stmg or proposed, and indicate oil set-back dimensions fro~ property hnes. Give street and block numbers or description according to deed, and show street names and mdlca whether interior or corner lot. STATE OF NEVf-YOR~f,~ · /~ ~ ............................. :....:... ............... : ........................................ being duly sworn, deposes and says that he is the appli (Nome of individual s,gmng application) above named. He is the .......... ~~....f_~:~ ................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make ant th~s opplicahon, that all statements contained in th~s ap. plication are true to the best of his know~dge and b and that the work wdl be performed in the. manner set forth in the applicahon filed therl~Ft~. Sworn to before me this __, ~/ / /' l· /~/' ' ...... : ................... doy f ............ ............. , , .-:--, / ..~2~4..~,,, /~ ~ c~,"~. ......~ ., .z ..... ~.. ...................... cor~m~ss~O~ ~x~